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medial menisectomy only?

  1. Default medial menisectomy only?
    Medical Coding Books
    So i have the doctor saying he performed a medial menisectomy only? but please read the following?

    the medial meniscus was inspected and palpated and found to have a horizontal cleavage tear at the mid to posterior horn, there was also some tearing of the medial border of mid to posterior horn. this was present through the medial infrapatellar arthroscopic portal. the arthroscopic shaver was introduced and the tear was resected followed byuse of the Mitek radiofrequency probe to sculpt this down to a stable edge.

    then he goes to the lateral compartment & dictates:

    there was noted to be some slight degenerative fraying of the medial border of the lateral meniscus. however no tears were found on palpation of the superior and inferior articular surfaces and the popliteal hiatus was inspected and found to be intact. The Mitek radiofrequency probe was then used to sculpt the medial border down to a stabilize edge.

    So no lateral meniscal tear is mentioned but can't I bill for a chondroplasty 29877?

  2. Default
    You cannot bill the chrondroplasty because it is bundled per the CCI and cannot be unbundled.

  3. Default
    You can bill 29877 since it is in a seperate compartment with a 59 modifier. Some insurances perfer G0289(Medicare Rules). Please check with the insurance guidelines.

    List of compartments;


    Kim, CPC

  4. Default
    Also, here is the note from one of Karen Zupko's Seminars

    A meniscal repair and chondroplasty done in the same compartment are considered "included" and not separately reportable. However, when done in separate compartments, the chondroplasty is separately reportable with the modifier 59 (per CPT rules) appended to indicate a distinct procedure service. Remember that according to CPT rules, a chondroplasty is only reported onece, regardless of how many areas are debrided or shaved. Accurate diagnosis coding and linking of diagnoses to procedures is important.

  5. Default
    I thought I could bill the chondroplasty separately but another thing I just noticed, since I work at an ASC I only have the op report, & as far as the diagnosis goes, it only states, degenerative fraying in the body of report??

  6. #6
    Look at the 717.4x codes for lateral compartment degenerative meniscus. Also, you may want to take a closer look at 29881/29880 which includes meniscal shaving.
    Last edited by coderguy1939; 08-11-2009 at 08:39 AM.

  7. Default
    that's what I am trying to find out, I shouldn't bill for 29880 b/cuz that is both medial & lateral, but he states there is no tears of the lateral mensicus, so to me he did not do a mensiectomy but only shaving of medial border of the mensicus (not menisectomy), so not sure if this should count as a chondroplasty??

  8. Default
    The description of 29877 in Ortho Companion indicates the cartilage can be frayed, but it states repair is done by motorized suction cutter or shaver and use of probe. Our office never used this Mitek device, so I am not exactly sure what it looks like and how it sculpts. If this probe is similar to the standard probe, I would say this is not separately billable since a shaver or cutter must be involved.

    717.4x range would be good for dx code.

    I hope this helps

  9. #9
    The note states that there was degenerative fraying of the medial border of the lateral meniscus and he stabilized it.

    Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
    Mary, CPC, CANPC, COSC

  10. Default
    now he says he wants to bill cpt 29881 because its an MVA case, & the medial meniscus tear is the injury related to MVA, so now Im just not sure how to bill for this, should I just bill 29881, or should he have done two separate op notes, I mean Im confused, how can I split this case , if even possible?

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